Finding an affordable medical aid scheme that is right for you can sometimes be more painful than a broken leg or a collapsed lung. With over 97 medical schemes registered in South Africa with the Council of Medical Schemes, it’s hardly surprising that most people would rather pull out their hair than make the effort of finding an affordable medical aid plan that fits.
Besides that, it’s quite tough finding yourself in the unknown world of medical terms, not knowing the difference between chronic medication and a once off prescription. All whilst having to fit whatever it is you’re paying for into your already thin budget. But fear not, there are experts just waiting to assist you in making that big decision.
The first thing to do is to look at your budget and make sure that the medical aid scheme you are looking at fits your pocket. It may help to cut and trim on other luxuries where you can to allow for the best possible cover.
The best place to start is with your specific needs. Are you a single young and healthy person looking only to cover yourself against unexpected hospital bills, or are you constantly bogged down with something and in constant need of medical check-ups, doctors’ visits and operations? Is it just you and your spouse, or do you have a family and their medical needs to take into account?
To give you an example: the top notch Discovery medical aid package, called the Executive Plan, will cost you a monthly payment of R3 764. This covers costs like unlimited hospital cover, comprehensive cover for chronic medicine and even limited medical emergencies when travelling outside South Africa, amongst other benefits.
The Classic Delta Core package from Discovery will set you back a mere R1 081 per month, but your benefits will be limited. Although you will have access to unlimited hospital cover in any private hospital as well as essential cover for chronic medication, it excludes benefits like a Medical Savings Account amount to cover your day-to-day healthcare needs, screening and prevention as well as cover for evidence-based treatment not available in South Africa, to name but a few.
If you look at Maxima Core option at Fedhealth, it is very similar to Classic Delta Core package from Discovery. At R1 166 per month, it mainly covers hospitalisation and chronic medicine (with additional payments for both). It has no day-to-day benefits, meaning that it doesn’t cover visits to the doctor or dentist.
So what’s really important is to figure out exactly what your immediate needs might be for the next year or so. If you go to the doctor once or twice a year it’s best to focus on just a hospital plan to make sure that you are covered in case of an unforeseen emergency. However, if you are in need of constant dental care or get sick often, a more comprehensive benefit plan would work better.
All of this will be held into account when choosing the best medical aid plan for you. Also, if you are unsure of anything stipulated on the plan, make a point to ask your broker about it. It is better to be sure and know what you are paying for than ending up in hospital with a broken nose and being unsure of what is covered or not.